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Background: Mexican migrants traveling across the Mexico-United States (U.S.) border region represent a large, highly mobile, and socially vulnerable subset of Mexican nationals. Population-level health data for this group is hard to obtain given their geographic dispersion, mobility, and largely unauthorized status in the U.S. Over the last 14 years, the Migrante Project has implemented a unique migration framework and novel methodological approach to generate population-level estimates of disease burden and healthcare access for migrants traversing the Mexico-U.S. border. This paper describes the rationale and history of the Migrante Project and the protocol for the next phases of the project. Methods/design: In the next phases, two probability, face-to-face surveys of Mexican migrant flows will be conducted at key crossing points in Tijuana, Ciudad Juarez, and Matamoros (N = 1,200 each). Both survey waves will obtain data on demographics, migration history, health status, health care access, COVID-19 history, and from biometric tests. In addition, the first survey will focus on non-communicable disease (NCD), while the second will dive deeper into mental health and substance use. The project will also pilot test the feasibility of a longitudinal dimension with 90 survey respondents that will be re-interviewed by phone 6 months after completing the face-to-face baseline survey. Discussion: Interview and biometric data from the Migrante project will help to characterize health care access and health status and identify variations in NCD-related outcomes, mental health, and substance use across migration phases. The results will also set the basis for a future longitudinal extension of this migrant health observatory. Analyses of previous Migrante data, paired with data from these upcoming phases, can shed light on the impact of health care and immigration policies on migrants' health and inform policy and programmatic responses to improve migrant health in sending, transit, and receiving communities.
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COVID-19 , Doenças não Transmissíveis , Transtornos Relacionados ao Uso de Substâncias , Migrantes , Estados Unidos , Humanos , MéxicoRESUMO
Cancer is one of the leading causes of mortality in the world. Despite the existence of diverse antineoplastic treatments, these do not possess the expected efficacy in many cases. Knowledge of the molecular mechanisms involved in tumor processes allows the identification of a greater number of therapeutic targets employed in the study of new anticancer drugs. In the last decades, peptide-based therapy design using computational chemistry has gained importance in the field of oncology therapeutics. This work aims to evaluate the electronic structure, physicochemical properties, stability, and inhibition of ETFS amino acids and peptides derived from the p53-MDM2 binding domain with action in cancer cells; by means of chemical descriptors at the DFT-BHandHLYP level in an aqueous solution, and its intermolecular interactions through molecular docking studies. The results show that The ETFS fragment plays a critical role in the intermolecular interactions. Thus, the amino acids E17, T18 and S20 increase intermolecular interactions through hydrogen bonds and enhance structural stability. F19, W23 and V25 enhance the formation of the alpha-helix. The hydrogen bonds formed by the backbone atoms for PNC-27, PNC-27-B and PNC-28 stabilize the α-helices more than hydrogen bonds formed by the side chains atoms. Also, molecular docking indicated that the PNC27B-MDM2, PNC28B-MDM2, PNC27-MDM2 and PNC28A-MDM2 complexes show the best binding energy. Therefore, DFT and molecular docking studies showed that the proposed peptides: PNC-28B, PNC-27B and PNC-28A could inhibit the binding of MDM2 to the p53 protein, decreasing the translocation and degradation of p53 native protein.
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Aminoácidos , Proteína Supressora de Tumor p53 , Proteína Supressora de Tumor p53/química , Simulação de Acoplamento Molecular , Aminoácidos/farmacologia , Aminoácidos/metabolismo , Teoria da Densidade Funcional , Proteínas Proto-Oncogênicas c-mdm2/química , Peptídeos/química , Ligação ProteicaRESUMO
Capsaicin is the main compound responsible of the hot sense of the chili fruits. This compound has interesting therapeutic properties including anticancer, anti-inflammatory effects, and analgesic. However, its use has several secondary effects, such as skin irritation and allergies. Then, new therapeutic strategies are searched in order to overcome these problems. Montmorillonite has proved to be an excellent excipient for the release of pharmaceutical drugs. In this work, the molecular structure and crystal structure of capsaicin, and the adsorption of this molecule into the interlayer space of montmorillonite have been studied using quantum mechanical calculations based on Density Functional Theory (DFT) level of theory and molecular dynamics simulations. The crystal structure has been predicted with these calculations and the intermolecular interactions have been determined with a higher resolution than the previous experimental data. The adsorption of capsaicin into the confined interlayer space of montmorillonite is energetically favourable with low and high octahedral charge. This adsorption can be monitored by IR spectroscopy observing frequency shifts in some bands during the adsorption. This enhances the use of these clay minerals for capsaicin therapeutic formulations.
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Bentonita , Capsaicina , Bentonita/química , Teoria da Densidade Funcional , Adsorção , ArgilaRESUMO
Primary liver tumors are rare in childhood. Hepatoblastoma is the most prevalent and has a variable clinical presentation. The initial approach requires clinical suspicion, histopathological confirmation, and measurement of AFP levels, in addition to PRETEXT staging by abdominal computed tomography. PET-CT is useful in metastatic disease for diagnosis and evaluation of therapeutic response. Pulmonary metastases at the time of diagnosis are frequent, while bone metastases are rare. We present the case of an infant with a history of metastatic hepatoblastoma, multiple relapses, and poor response to multimodal management. The patient had bone metastases demonstrated by PET-CT imaging.
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Chagas disease is caused by Trypanosoma cruzi. Benznidazole and nifurtimox are drugs used for its therapy; nevertheless, they have collateral effects. NADH-fumarate (FUM) reductase is a potential pharmacological target since it is essential for survival of parasite and is not found in humans. The objectives are to design and characterize the electronic structure of imidazole and nitroimidazole derivatives at DFT-M06-2X level in aqueous solution; also, to model the NADH-FUM reductase and analyze its intermolecular interactions by molecular docking. Quantum-chemical descriptors allowed to select the molecules with the best physicochemical properties and lowest toxicity. A high-quality three-dimensional structure of NADH-FUM reductase was obtained by homology modeling. Water molecules do not have influence in the interaction between FUM and NADH-FUM reductase. The main hydrogen-binding interactions for FUM were identified in NADH, Lys172, and Arg89; while hydrophobic interactions in Phe479, Thr174, Met63. The molecules S3-8, S2-8, and S1-8 could be inhibitors of NADH-FUM reductase.
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Nitroimidazóis , Oxirredutases atuantes sobre Doadores de Grupo CH-CH , Teoria da Densidade Funcional , Inibidores Enzimáticos/química , Inibidores Enzimáticos/farmacologia , Humanos , Imidazóis/farmacologia , Simulação de Acoplamento Molecular , NAD , Nitroimidazóis/farmacologiaRESUMO
este artículo de reflexión hace un llamado a retornar a la compasión y el profesionalismo médico que se han visto sensiblemente afectados por la pandemia. En el contexto de la pérdida de un familiar, los autores reflexionan sobre los medicamentos vitales no disponibles para aliviar el sufrimiento y el dolor de los pacientes que se encuentran al final de la vida. El texto invita a los pacientes a ejercer su derecho a la salud y a la muerte digna y hace un llamado a los lectores a pensar en la investigación e innovación como alternativas para enfrentar la coyuntura nacional de escasez de medicamentos y dispositivos médicos.
This reflective article calls for a return to compassion and medical professionalism that have been sensitively affected by the pandemic. In the context of bereavement, the authors reflect on the vital medications unavailable to alleviate the suffering and pain of patients at the end of life. The text invites patients to exercise their right to health and dignified death and calls on readers to think about research and innovation as alternatives to confront the national conjuncture of shortages of medicines and medical devices.
neste artigo de reflexão, pede-se um retorno à compaixão e ao profissionalismo médico que foram sensivelmente afetados pela pandemia da covid-19. No contexto do luto, os autores refletem sobre os medicamentos vitais indisponíveis para aliviar o sofrimento e a dor dos pacientes no final da vida. O texto convida os pacientes a exercerem seu direito à saúde e a uma morte digna, e convoca os leitores a pensarem em pesquisa e inovação como alternativas para enfrentar a escassez nacional de medicamentos e dispositivos médicos.
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Humanos , Dor , Direito a MorrerRESUMO
RESUMEN Introducción. En hematología, el estudio de las alteraciones de la morfología eritrocitaria contribuye con el diagnóstico de la normalidad o anormalidad de estas estructuras, sin embargo, el carácter cualitativo de los criterios diagnósticos dificulta su interpretación y alcance. Objetivo. Caracterizar los eritrocitos nucleados de tilapia roja (Oreochromis spp), en el contexto de la geometría fractal y euclidiana. Metodología. Se tomaron 50 eritrocitos nucleados de 20 extendidos de sangre de tilapia roja. Posteriormente todos los contornos del núcleo y el citoplasma de los eritrocitos fueron delineados, para superponer dos rejillas, una con el doble tamaño que la otra, para calcular mediante el método de Box Counting la dimensión fractal de cada eritrocito delineado. Adicionalmente fue calculada la superficie de estas dos partes del eritrocito. Resultados: Los resultados de este estudio revelaron que los valores de la dimensión fractal no permiten hacer comparaciones entre eritrocitos nucleados. Por su parte, la superposición de rejillas de 5x5 y 10x10 píxeles permitió observar que los valores de ocupación del citoplasma y el núcleo permiten hacer comparaciones entre los eritrocitos nucleados, junto con los valores de la superficie de estas dos partes del eritrocito nucleado. Conclusión: Los eritrocitos nucleados de tilapia roja pueden ser caracterizados mediante la medición de los valores espacios ocupados por su citoplasma y el núcleo, junto con los valores de la superficie de cada una de estas dos partes del eritrocito.
ABSTRACT Introduction. In hematology, the study of erythrocyte morphology alterations contributes to the diagnosis of normality or abnormality of these structures. However, the qualitative nature of the diagnostic criteria makes their interpretation and scope difficult. Objective. Characterize the nucleated erythrocytes of red tilapia (Oreochromis spp) in the context of fractal and Euclidean geometry. Methodology. Fifty nucleated erythrocytes were taken from twenty red tilapia blood smears. Subsequently, all the contours of the nucleus and the cytoplasm of the erythrocytes were delineated to superimpose two grids, one twice the size of the other, to calculate the fractal dimension of each delineated erythrocyte using the Box Counting method. Additionally, the surface of these two parts of the erythrocyte was calculated. Results: This study revealed that the fractal dimension values do not allow comparisons between nucleated erythrocytes. The superposition of 5x5 and 10x10 pixel grids allowed us to observe that the occupancy values of the cytoplasm and the nucleus allow comparisons between the nucleated erythrocytes, together with the values of the surface of these two parts of the nucleated erythrocyte. Conclusion: Red tilapia nucleated erythrocytes can be characterized by measuring the values of the spaces occupied by their cytoplasm and nucleus, together with the values of the surface of each of these two parts of the erythrocyte.
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Introducción: Los valores de la frecuencia cardiaca normales y anormales registrados en los equipos electrocardiográficos ambulatorios o continuos han sido caracterizados mediante nuevas metodologías diagnósticas, las cuales se han desarrollado en el contexto de la teoría de los sistemas dinámicos y la entropía. Objetivo: Evaluar la dinámica cardiaca de adultos, teniendo en cuenta su comportamiento en el contexto de la teoría de sistemas dinámicos y las proporciones de la entropía mediante un estudio ciego. Métodos: Se realizó una prueba diagnóstica mediante un estudio ciego de 500 Holter, aplicando una nueva metodología basada en las proporciones de la entropía del atractor numérico construido con los valores registrados en el Holter. Para esto, los valores máximos y mínimos de la frecuencia cardiaca para cada hora, así como el número de latidos, fueron tomados de cada Holter durante, mínimo, 18 horas. Con estos valores se generó un atractor numérico que cuantificó la probabilidad de parejas de frecuencias cardiacas consecutivas. Se evaluó cada dinámica a partir de los valores de entropía y de sus proporciones. Posteriormente, estos resultados fueron comparados con la evaluación clínica convencional estimando la sensibilidad y especificidad, así como el coeficiente Kappa. Resultados: Se encontraron diferencias entre la dinámica de casos normales y anormales, en las dinámicas cardiacas evaluadas en 18 horas, hallando valores de sensibilidad y especificidad del 100 por ciento y coeficiente Kappa de uno, respecto al diagnóstico clínico convencional. Conclusiones: Los valores de entropía y de sus proporciones permiten diferenciar cuantitativamente la normalidad de la enfermedad en la dinámica cardiaca, durante un mínimo de 18 horas(AU)
Introduction: The normal and abnormal heart rate values recorded on ambulatory or continuous electrocardiographic devices have been characterized with novel diagnostic methodologies developed in the context of dynamic systems and entropy theory. Objective: Through a blind study, evaluate the heart dynamics of adults taking into account their behavior in the context of dynamic systems theory and entropy proportions. Methods: A diagnostic test was conducted through a 500 Holter blind study, applying a novel methodology based on the entropy proportions of the numerical attractor constructed with the values registered on the Holter device. To achieve this end, maximum and minimum heart rate values for each hour, as well as the number of beats, were obtained from each Holter device for at least 18 hours. Based on these values, a numerical attractor was generated which quantified the probability of consecutive heart rate pairs. Each dynamic was evaluated in terms of entropy values and their proportions. These results were then compared with the conventional clinical evaluation, estimating the sensitivity and specificity as well as the kappa coefficient. Results: Differences were found between the dynamics of normal and abnormal cases, in the heart dynamics evaluated in 18 hours, finding sensitivity and specificity values of 100 percent and a kappa coefficient of 1, with respect to conventional clinical diagnosis. Conclusions: Entropy values and their proportions make it possible to quantitatively differentiate the normality of the disease in heart dynamics for a minimum of 18 hours(AU)
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Humanos , Comportamento , Diagnóstico Clínico , Equipamentos e Provisões , Identidade de Gênero , Coração , Frequência Cardíaca/fisiologia , Testes Diagnósticos de RotinaRESUMO
PURPOSE: The gold standard for the diagnosis of Hirschsprung's disease (HD) is a rectal biopsy. The sample may be obtained using a transanal excisional biopsy (TEB) or suction technique. Rectal suction biopsy (RSB) is not a standard procedure in Latin-America. AIM: To evaluate the current practice in rectal biopsy for HD among pediatric surgeons. METHODS: We distributed an online questionnaire among Latin-American pediatric surgeons. RESULTS: One hundred forty-nine pediatric surgeons from 15 countries completed the anonymous survey (71.4% of Latin-American countries), grouped into 81.9% pediatric surgeons; 8.9% pediatric colorectal surgeons, 8.9% trainees, and 1 pediatric colorectal surgeon fellow. 50.4% reported less than 5 new patients with HD per year, 36.2% 5-10 new cases, and 13.4% more than 10. Only 14.1% of surgeons have access to perform a RSB in the diagnostic work-up of patients with suspected HD, 90% in our study perform an TEB under general anesthesia. When we ask if they could perform both procedures in babies up to 6 months, 52.3% indicate that they prefer an RSB, and for patients older than 6 months, 35.4% favor an RSB. Regarding the number of samples obtained performing an TEB, 30.9% get one biopsy, 29.5% two biopsies, and 39.6% three or more samples. Surgeons obtained the most proximal biopsy at a median of 2.3 cm (range 1-4 cm) above the pectinate line. 67.8% of surgeons prescribed antibiotic prophylaxis. Overall, 16.1% experienced complications, including rectal blood loss (n = 18), and rectal perforation (n = 3). The most frequently used staining methods for rectal biopsies are hematoxylin/eosin (87%), calretinin (56, 8%), and acetylcholinesterase (21.9%). CONCLUSIONS: In Latin-America, the accessibility for RSB is limited only 18 out of 149 surgeons have access to rectal suction tool. There is no consensus regarding sample number, site of proximal biopsy, and antibiotics use. The complications associated with the procedure seems to be less than reported with RSB. Therefore, we should standardize this common surgical practice and establish universal guidelines for rectal biopsy procedure (RBP).
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Biópsia/métodos , Doença de Hirschsprung/diagnóstico , Pediatria , Cirurgiões , Acetilcolinesterase , Calbindina 2 , Criança , Procedimentos Cirúrgicos do Sistema Digestório , Feminino , Humanos , Lactente , Recém-Nascido , Perfuração Intestinal , América Latina , Masculino , Doenças Retais/patologia , Reto/patologia , Sucção , Inquéritos e QuestionáriosRESUMO
Increasingly, researchers and practitioners are examining connections between public and private cycles of violence. In complex emergency settings, these cycles of violence often intersect with conflicting norms and values as societies work toward sustainable peace. Gender norms, particularly norms of masculinity, are not often highlighted in transdisciplinary violence studies. Furthermore, few studies on either subject capture the perspectives and experiences of adolescent boys. This study seeks to explore adolescent boys' (13-17 years) experiences with violence at home and in the community in "post-conflict" Colombia. Thematic qualitative analysis of 20 interview transcripts from 14 Colombian boys in Cundinamarca (n = 5) and Córdoba (n = 9) revealed themes of conflict avoidance, hegemonic masculinity, and opportunities for change in the form of positive coping habits. Further research into social and emotional coping behaviors and linkages to perpetuating violence between adolescence and adulthood is needed.